Pediatric to Adult Care Transition

Med-Peds physicians have an essential role to play in facilitating timely, effective transitions from pediatric to adult care. The Prisma Health Med-Peds program is dedicated to providing our residents with the knowledge, skills, and experience to help young adults transition to the adult health care setting. Our Med-Peds residents receive transitional care training through clinical experiences, workshops, and didactics throughout the four years of training.

Our residency program director, Sarah Hinton, leads our health system as the chair for the Pediatric to Adult Care Transition Committee. She has also received two grants from the American Academy of Pediatrics to improve pediatric to adult care transition for individuals with intellectual disabilities and developmental delays across South Carolina. Additionally, our resident continuity clinic sites, the Center for Pediatric Medicine and the Internal Medicine Clinic have played an integral role in piloting pediatric to adult care transition projects, which have been later implemented across the health system. Med-Peds residents’ efforts have also resulted in two quality improvement poster presentations at the annual meeting of the South Carolina chapter of the American Academy of Pediatrics.  

Pediatric to Adult Care Initiatives:

  • In 2015, Sen Ravindran, our Associate Program Director and a 2015 graduate of our program and Jill Sullivan, a 2015 graduate, planned a TransitionalCare Conference, attended by students and physicians from across the country.
  • In 2016, we recognized that despite having a nationally recognized asthma management program in our pediatric resident clinic, we did not have a formal process for transitioning our asthma patients to adult care. Utilizing the Six Core Elements from Got Transition, we developed an office policy regarding transition and transfer to adult care.
  • We then created a transition readiness assessment tool to be administered at least yearly during asthma maintenance visits. A clinic quality improvement project showed that our EHR tool’s utilization resulted in improved transition planning and improved outcomes in our clinic asthma population. We then broadened the use of our EHR tool for use for our entire clinic population for use during routine preventive wellness visits. Following this tool’s successful utilization in our residency clinic population, the tool was encouraged for use across the entire pediatric population in our region for our health system for both general pediatric practices and subspecialty practices.
  • Med-Peds residents helped with the creation of our clinic policy and transition assessment tool.

Continued work on transition has resulted in creating a new referral type in the electronic health record, allowing patients and providers to identify an appropriate fit for an adult provider or practice. Additionally, recognizing that there is sometimes confusion and difficulty managing patients near the age of transition in the emergency and inpatient settings, a proposal for an EHR dashboard has been created. This dashboard would help highlight the patient’s transition plan and important need-to-know information. 

There are many opportunities for resident involvement in quality improvement projects involving transitional care in our system.

 

 

 

 

 

Below is the agenda and materials from our 2015 Transitional Care Conference:

8:15-9:15 a.m.

Keynote Lecture: Implementation and Evaluation of Transition Quality Improvements in Pediatric and Adult Health Care Settings Using the New Six Core Elements of Health Care Transition. Peggy McManus, The National Alliance to Advance Adolescent Health/Got Transition, Washington, DC.

 

9:15-10:15 a.m.

Plenary Session 1: This Week at the Children’s Museum: How to Build an Adult Congenital Heart Center. Dr. Manisha Patel, Director Adult Congenital Heart Disease Clinic, Greenville Health System, Greenville, SC.

 

10:30-11:30 a.m.

Plenary Session 2: Transition to Adult Care among Adolescents with Perinatally-acquired HIV: Perspectives of Adolescents, Guardians, and ProvidersDr. Cynthia Fair, Professor of Human Services, Elon University, Elon, NC.

 

11:30-12:30 p.m.

Plenary Session 3: The Medical Home. Dr. Sean Bryan, Chair Family Medicine, Greenville Health System, Greenville, SC.

 

12:30-1:45 p.m.
Lunch – Transitional Care Poster Sessions
 

1:45-2:45 p.m.

Plenary Session 4: Sickling Smoothly through Life: Insights from Sickle Cell TransitionDr. Nirmish Shah, Director Sickle Cell Transition Program, Duke University Medical Center, Durham, NC.

 

2:45-3:45 p.m.

Plenary Session 5: Providing Care to Adolescents and Young Adults with Type 1 Diabetes MellitusDr. Bryce Nelson, Pediatric Endocrinology, Greenville Health System, Greenville, SC.

 

3:45-4:45 p.m.
 

4:45-5:45 pm
Roundtable Discussion

Saturday, May 16

 

 

 

 

 

8:30-9:30 a.m.

Plenary Session 1: Transition Care: Future Directions in Professional Education and Curriculum Development. Dr. Kitty O’Hare, Director of Transition Medicine for Primary Care, Boston Children’s Hospital and Harvard Medical School, Boston, MA

 

9:30-10:30 a.m.

Plenary Session 2: Practical Methods of Transition and Transition Initiatives in Private Practice. Dr. Stefanie Putnam, Heritage Internal Medicine and Pediatrics, Greenville, SC.

 

10:30-11:30 a.m.

Plenary Session 3: Healthcare Transitions for Adolescents and Young Adults with Developmental DisabilitiesDr. Tom Webb, Novant Health, Thomasville, NC.

 

11:30-12:30 p.m.
Lunch – Meet your Pediatric and Adult Counterparts
 

12:30-1:30 p.m.

Plenary Session 4: Cerebral Palsy – One Size Does Not Fit AllDr. Mary Brake Turner, East Carolina University, Greenville, NC.

 

1:30-2:30 p.m.

Plenary Session 5: The Medical Legal Partnership Greenville Health System. Kirby Mitchell, SC Legal Services, Greenville, SC

 

2:30-3:30 p.m.

Plenary Session 6: Legal Issues Related to the Acre of Transition Age Patients.Mr. Chuck Crews, Crews Law Offices, Greenville, SC.

 

3:30-4:00 p.m.
Plenary Session 7: Update on Electronic Medical Records and Mobile Platforms in Transitional Healthcare. Dr. Jill Sullivan, Internal Medicine-Pediatric Residency Program, Greenville, SC.
 

4:00 p.m.
Closing Remarks and Adjourn